Doulas

What Does a Doula Do?

A doula is a woman who provides emotional, physical, and informational support to a laboring woman. She helps with comfort measures such as breathing, hot/cold compresses, suggestions with positions, and massage. She offer suggestions that can change the progress of your birth. Many offer birthing ball techniques, aromatherapy, acupressure, and a ‘big bag of tricks.’ She reassures the laboring family and can help with fears or emotional times. She can point out interventions and explain them in layman’s terms.

A good professional labor coach does whatever you need her to do. Speaking from personal experience, that can mean letting the partner do most of the support and offering occasional suggestions or being the only support person while the father waits out in the hall and checks in occasionally. It can mean offering sips of water and words of encouragement, giving massage for twelve plus hours, slow dancing with a laboring woman, or everything in-between.

Statistically, women with doulas need fewer cesareans, less pain medicine, less instrumental births (forceps and vacuums), and less pitocin augmentation. They also report shorter labors, more pleasant birth experiences, and better bonds with their new babies. Women with professional labor coaches have an easier experience with breastfeeding and continue breastfeeding longer than women who did not have a doula.

What Don't They Do?

Doulas are not medical professionals. She should never perform medical procedures such as vaginal exams, blood pressure checks, or fetal heart checks. She can explain procedures to a laboring woman—-explain why they need to do a fetal heart check or a blood pressure check, but she should never interpret the information.

A professional labor coach can explain what dilation, effacement, and station mean. She can give pros and cons to interventions such as pitocin and an epidural. However, she cannot make decisions for a laboring woman. She should not ever send a doctor from the room or threaten to leave if the mom gets an intervention. Her job is to do whatever the mom needs her to do, even if that means supporting interventions she personally disagrees with.

How Does She Work with Partners?

A good professional labor coach will work with your partner, not against him. She will probably have met with you and your partner before the birth to determine how much your partner wants to be a part of the birth. She may offer your partner suggestions on ways to help, if he wants to help. During the birth, she will remind your partner to eat, rest, and take restroom breaks. Her job is to support not only you but your partner as well.

A good doula does not replace the partner. She cannot share the love or connection you two share. Your partner will show his love and give his strength to you during your labor. Your professional labor coach cannot do this, nor should she try.

What if I Don’t Want a Natural Childbirth?

That’s okay! A lot of women know from the start they want an epidural or narcotics. A doula can still help you with comfort techniques until you get your epidural and provide emotional or informational support. She can help you when it comes time to push and provide assistance with breastfeeding after your baby is born.

When you interview for a professional labor coach, you will want to find one who understands what you want and will support your choices. These women are becoming more mainstream. You shouldn’t have any issues finding one who will support your choices. A good professional labor coach will not try to talk you into a natural childbirth if that’s not what you want.

How Do I Find a Professional Labor Coach?

Most hospitals do not offer doulas on staff, though there are exceptions. Professional labor coaches are privately hired and contracted with the pregnant family, not with your care provider.

There are many national doula organizations that offer certification programs. A certified doula is one who has gone through a certification process. The process varies depending on the organization, but usually includes reading, a training requirement, reviewed births, written essays, and possibly a written test. National organizations include DONA, CAPPA, ICEA, Childbirth International and ALACE. These organizations offer referrals to their doulas.

You can also look locally. Many advertise in the phone book or have websites. Your midwife or Ob-Gyn may have suggestions as well. You can also talk to your friends and check with breastfeeding and baby stores.

When you find a professional labor coach you’re interested in, you should interview her in person if possible. Questions to ask include:

• What training and education have you received?
• What is your philosophy about childbirth and supporting women and their partners through labor?
• When do you join women in labor? At our home or at the place of birth?
• Will you meet with us to discuss our birth plans and the role that you will play in supporting us through childbirth?
• May we call you with questions or concerns before or after the birth?
• Do you work with one or more backup doulas for times when you are not available? May we meet them?
• What is your fee, what services does it include, and what are your refund policies?
• Will you provide references?

Of course this is just a basic list of questions. You can ask her anything you want to ensure she matches what you want for your birth.